Sleep Quality Index Total Score Research Articles

Sleep quality and sex-related differences in an older adult population: a web-based cross-sectional study

Introduction: Aging has significant economic and social implications leading to an increase in chronic diseases and reduced autonomy of the elderly. Sleep disorders are common in the elderly, manifesting reduced sleep quality. Objective/Purpose: The study aimed to measure the prevalence of sleep disorders in older adults and assess sex differences in sleep quality and sleep problems. Method: A cross-sectional study based on an online survey was performed according to the STROBE checklist, using pre-validated questionnaires (Pittsburgh Sleep Quality Index) distributed to a sample of older adults. This is the first study evaluating sex differences in sleep quality and problems in the Italian population context using the Pittsburgh Sleep Quality Index assessment tool. The study was conducted in a university hospital in Rome from October 2020 to November 2020, on patients aged >65 years, independent in activities of daily living, with comorbidities and on treatment with up to 2 medications. Results: 59 patients were included in the study, with an average age of 71.12 years. The results show that among males, the prevalence of poor sleep quality was 51.9%, while among females, the prevalence of poor sleep quality was 62.5%. According to Shapiro-Wilk, the Pittsburgh Sleep Quality Index was not normally distributed. Pittsburgh Sleep Quality Index total scores in males did not differ significantly from females. Conclusions: Considering scientific literature, recent studies have highlighted the prevalence of sleep disorders in the elderly population and their underreporting. Providing early intervention not only improves the sleep quality of these people but may also reduce the risk of experiencing adverse health outcomes and susceptibility to frailty.

Psychosocial outcomes with the Omnipod® 5 Automated Insulin Delivery System in caregivers of very young children with type 1 diabetes.

Automated insulin delivery (AID) systems have demonstrated improved glycaemic outcomes in people with type 1 diabetes (T1D), yet limited data exist on these systems in very young children and their impact on caregivers. We evaluated psychosocial outcomes following use of the tubeless Omnipod® 5 AID System in caregivers of very young children. This 3-month single-arm, multicentre, pivotal clinical trial enrolled 80 children aged 2.0-5.9 years with T1D to use the Omnipod 5 AID System. Caregivers completed questionnaires assessing psychosocial outcomes-diabetes distress (Problem Areas in Diabetes), hypoglycaemia confidence (Hypoglycemia Confidence Scale), well-being (World Health Organization 5 Well-Being Index), sleep quality (Pittsburgh Sleep Quality Index), insulin delivery satisfaction (Insulin Delivery Satisfaction Survey) and system usability (System Usability Scale) at baseline with standard therapy and after 3 months of AID use. Following 3 months of Omnipod 5 use, caregivers experienced significant improvements across all measures, including diabetes-related psychosocial outcomes (Problem Areas in Diabetes; p < 0.0001, Hypoglycemia Confidence Scale; p < 0.01), well-being (World Health Organization 5 Well-Being Index; p < 0.0001) and perceived system usability (System Usability Scale; p < 0.0001). Significant improvements were seen in the Pittsburgh Sleep Quality Index total score and the overall sleep quality, sleep duration and efficiency subscales (all p < 0.05). Insulin Delivery Satisfaction Survey scores improved on all subscales (greater satisfaction, reduced burden and reduced inconvenience; all p < 0.0001). Caregivers face unique challenges when managing T1D in very young children. While glycaemic metrics have unquestioned importance, these results evaluating psychosocial outcomes reveal additional meaningful benefits and suggest that the Omnipod 5 AID System alleviates some of the burdens caregivers face with diabetes management.

Effects of Somatosensory Games on Heart Rate Variability and Sleep-Related Biomarkers in Menopausal Women With Poor Sleep Quality.

The aim of this study was to investigate the effects of 12-week somatosensory games on heart rate variability and sleep-related biomarkers in middle-aged women with poor sleep quality. Twenty-nine women with poor sleep quality were recruited as participants randomly assigned into ring fit adventure exergame group (RFA, n = 15) and control group (CON, n = 14). The RFA group received ring fit adventure exergame for 60min each time, 2 times a week, for 12 weeks. The CON group was not allowed to participate in intervention activities during the study period. Heart rate variability, sleep quality, cortisol, serotonin, and high-sensitive C-reactive protein were measured before and after the 12-week intervention. The Pittsburgh Sleep Quality Index total score in the RFA group was significantly lower compared with the CON group. The value of the standard deviation of normal NN intervals and the root mean square of the successive RR Differences were significantly increased in the RFA group, when compared with the CON group. The change in the logarithm of high frequency (log HF) was significantly higher and change in the logarithm of low frequency to high frequency ratio (log LF/HF) was significantly lower in the RFA group, when compared to the CON group. The change level of serotonin in the RFA group was significantly higher compared with the CON group. The results suggest that somatosensory games might improve sleep quality, increase serotonin level, and decrease sympathetic nerve activities in middle-aged women with poor sleep quality.

Sleep quality and self-efficacy for managing chronic disease: A cross-sectional study in the elderly Population in Edirne Province

Objective: To examine the relationship between sleep quality and self-efficacy for managing chronic diseases in elderly individuals living at home in Edirne province. Methods: In this cross-sectional study, the data was collected through simple random sampling and home visits from 244 individuals aged 60 years and older between March and December 2018. The Pittsburgh Sleep Quality Index, the Self-Efficacy for Managing Chronic Disease 6-Item Scale, and the Interview Form were used in the study. The data was collected using descriptive analysis, t-test, one-way ANOVA, Pearson correlation, and linear regression analysis. Results: Most of the individuals (86.1%) had poor sleep quality and the mean Pittsburgh Sleep Quality Index total score was 7.16±3.04. The mean of Self-Efficacy for Managing Chronic Disease 6-Item Scale total score was 4.82±1.79. Sleep quality was worse in individuals who were women, single, retired, perceiving their health as bad, and with comorbidities (p˂0.05). There was a negative and significant relationship between the scales in correlation and regression analyses (p˂0.05). Conclusions: Self-efficacy in chronic disease management was an important factor in improving sleep quality. Healthcare professionals must be knowledgeable and experienced in practices that increase self-efficacy in primary care.

Sleep and Its Disturbance in Parents of Children and Adolescents with Epilepsy: A Systematic Review and Meta-Analysis.

Sleep disturbances are commonly reported by parents of children and adolescents with epilepsy. However, evidence synthesis including quality and quantity of sleep in parents of children and adolescents with epilepsy is lacking. This systematic review and meta-analysis was conducted to quantify pooled mean estimates of parental sleep variables and to determine the prevalence of sleep disturbances in parents of children and adolescents with epilepsy. Five electronic databases, PubMed, Medline, Embase, PsychINFO, and CINAHL, were systematically searched from inception to September 2021. Eleven observational studies examining parents of pediatric patients aged <18 years with epilepsy using a quantitative measure of sleep duration, sleep quality, or sleep disturbance were reviewed. Our results showed that the pooled nocturnal sleep duration was 5.93 hours (95% CI: 4.64 to 7.21 hours). Overall sleep quality as estimated by the bias-adjusted pooled Pittsburgh Sleep Quality Index total score was 6.65 (95% CI: 5.98 to 7.33). Parents of children with epilepsy had significantly higher Pittsburgh Sleep Quality Index total scores compared to parents of healthy children (differences in means 1.84, 95% CI: 1.29 to 2.39). The pooled estimated prevalence of parental sleep disturbances was 58.1% (95% CI: 45.7% to 69.6%). Our findings demonstrate a high prevalence of sleep disturbances with poor sleep quality and substantial reductions in sleep time in parents of children and adolescents with epilepsy. Healthcare professionals in pediatric neurology clinics should proactively initiate screening for sleep disturbances in parents of children and adolescents with epilepsy and refer parents to a sleep specialist when necessary.

Factors that predict pursuing sinus surgery in the era of highly effective modulator therapy.

Comorbid chronic rhinosinusitis (CRS) remains unresolved for many people with cystic fibrosis (PwCF). While highly effective modulator therapy improves quality-of-life and symptom severity, the impact of this intervention and other factors associated with pursuing endoscopic sinus surgery (ESS) remains understudied. Adult PwCF + CRS were enrolled into a prospective, observational, multi-institutional study. Participants completed validated outcome measures to evaluate respiratory symptom severity, depression, headache, and sleep quality, as well as nasal endoscopy, sinus computed tomography (CT), and olfactory testing. Bivariate comparisons and regression modeling evaluated treatment cofactors, disease characteristics, and outcome measures associated with pursuing ESS. Sixty PwCF were analyzed, including 24 (40%) who elected ESS. Pursuing ESS was associated with worse SinoNasal Outcome Test (SNOT-22) total, rhinologic, psychological, and sleep dysfunction domain scores; worse Patient Health Questionnaire-9-Revised depression scores; worse Pittsburgh Sleep Quality Index total scores; worse weight, role, emotion, and eating domain scores on the Cystic Fibrosis Questionnaire-Revised; more severe disease on nasal endoscopy; and lack of modulator therapy (all p<0.050). Multivariable regression identified that worse SNOT-22 total score was associated with electing ESS (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.02-1.16, p=0.015) and elexacaftor/tezacaftor/ivacaftor (ETI) treatment (OR 0.04, 95% CI 0.004-0.34, p=0.004) was associated with pursing medical therapy. Worse sinonasal symptom burden, lack of ETI treatment, sleep quality, depression, and nasal endoscopy scores were associated with electing ESS, while lung disease severity and sinus CT scores were not. ETI use was associated with lower odds of pursuing ESS independent of sinonasal symptom burden.

0782 Sleep and Its Disturbance in Parents of Children and Adolescents with Epilepsy: A Systematic Review and Meta-Analysis

Abstract Introduction Sleep disturbances are commonly reported by parents of children and adolescents with epilepsy. However, evidence synthesis including quality and quantity of sleep in parents of children and adolescents with epilepsy is lacking. A greater understanding of the characteristics of sleep patterns and sleep problems in parents of children with epilepsy is needed because when the sleep of the parents is compromised, the parents’ ability to provide quality care for the child may be hampered. The purpose of this systematic review and meta-analysis was to synthesize published studies examining sleep and its disturbance in parents of children and adolescents with epilepsy. Methods Five electronic databases, PubMed, Medline, Embase, PsychINFO, and CINAHL, were systematically searched from inception to September 2021. Studies examining parents or caregivers of pediatric patients aged &amp;lt; 18 years with epilepsy using a quantitative measure of sleep duration, sleep quality, or sleep disturbance were included. Available data were pooled using random-effects or fixed-effects models on the basis of heterogeneity between studies. Results Eleven observational studies with a total of 934 parents of children and adolescents with epilepsy were reviewed. The pooled nocturnal sleep duration was only 5.93 hours (95% CI: 4.64 to 7.21 hours). Overall sleep quality as estimated by the bias-adjusted pooled Pittsburgh Sleep Quality Index total score was 6.65 (95% CI: 5.98 to 7.33). Parents of children with epilepsy had significantly higher Pittsburgh Sleep Quality Index total scores in comparison to parents of healthy children (differences in means: 1.84, 95% CI: 1.29 to 2.39). The pooled estimated prevalence of parental sleep disturbances was 58.1% (95% CI: 45.7% to 69.6%). Conclusion Our findings demonstrate a high prevalence of sleep disturbances with poor sleep quality and substantial reductions in sleep time in parents of children and adolescents with epilepsy. Healthcare professionals in pediatric neurology clinics should initiate screening of sleep disturbances in parents and refer parents to a sleep specialist when necessary. Support (if any) This work was supported by Ministry of Science and Technology, Taiwan, MOST 110-2628-B-002-039.

Evaluation of Physical Activity Levels, Sleep Quality and Nutritional Habits of Paraathletes during the Pandemic Process

Background: Cancellation or postponement of sports organizations due to the Covid 19 pandemic has caused great stress for athletes. There are limited studies on how physical activity levels, nutritional habits and sleep quality are affected, especially in physically disabled athletes(paraathletes) during the pandemic process. &#x0D; Purpose: the aim of the research is to examine the physical activity, nutritional habits and sleep quality levels of paraathletes during the pandemic process.&#x0D; &#x0D; Method: Eighty- seven male paraathletes were included in the study. The personal data form required to determine the characteristics within the study subject International Physical Activity Questionnaire Short Form (IPAQ Short Form), the Pittsburg Sleep Quality Index Questionnaire were used in a way consistent with the study. In addition to these sections, changes in participants' nutritional habits were questioned. &#x0D; &#x0D; Results: Total MET values of paraathletes were determined as 3233 ± 1421. The sleep quality index total score averages of the participants were 5.83 ± 0.80 points, indicating the level of 'poor sleep quality'. Food consumption of the participants It was found that 56% of them increased their food consumption, 28% did not change, and 18% decreased.&#x0D; &#x0D; &#x0D; Conclusion: The results of the study showed that physical activity, nutrition and sleep processes, which have an important place in the life cycle of paraathletes, were adversely affected during the pandemic process.

The relationship between restless legs syndrome and motor subtype in patients with de novo Parkinson’s disease

Background: Restless legs syndrome (RLS) is a common sleep-related complication in patients with Parkinson’s disease (PD). The aim of this study was to assess the clinical characteristics associated with the occurrence of RLS in patients with de novo PD. Methods: Our study included 346 patients with de novo PD. The motor and non-motor status of each patient was assessed using the appropriate scales, and RLS was diagnosed through face-to-face interviews. Results: The incidence of RLS in patients with PD was 12.7% (44/346), while relative proportion of different motor subtypes was significantly different between PD patients with and without RLS. PD patients with RLS had lower rates of tremor-dominant subtype (25.0% vs. 36.4%) and higher rates of akinetic-rigid subtype (59.0% vs. 54.6%) (P&lt;0.001) than those without RLS. PD patients with the akinetic-rigid subtype had a higher prevalence of RLS (13.6%) than those with tremor-dominant subtype (9.0%) (P=0.020). The significant factors associated with the presence of RLS were modified Hoehn-Yahr stage, motor subtype, and Pittsburg Sleep Quality Index total scores. Conclusion: Our findings indicated a significant relationship between RLS and motor subtype in patients with PD and revealed that the motor subtype is a significant predictor of RLS in patients with PD.

Erenumab Impact on Sleep Assessed With Questionnaires and Home-Polysomnography in Patients With Migraine: The ERESON Study.

IntroductionMigraine and sleep share a complex and unclear relationship. Poor sleep may trigger migraine attacks; migraine, in turn, is frequently associated with sleep disorders. Few previous studies used questionnaires to assess sleep changes in patients who were treated with migraine-preventive medications (MPMs). More extensive polysomnography (PSG)-based studies for this purpose were not available.ObjectiveTo investigate possible sleep changes in patients with migraine treated with erenumab, using validated sleep questionnaires and home-PSG.MethodsThis observational, prospective, open-label pilot study was conducted at the Clinical Neurology Unit Headache Center of Udine University Hospital from 2020 to 2021. Patients were treated with erenumab as monotherapy or add-on treatment for migraine prevention. Sleep changes were evaluated with questionnaires and polysomnographic recordings at baseline, after 3 and 12 months of treatment. Erenumab efficacy and safety in migraine prophylaxis were also investigated.ResultsTwenty-nine patients completed 3 months of follow-up, whereas 15 patients completed 12 months. We found a weak trend of improvement in daytime somnolence after 3 months of treatment, with stronger results after 12 months (median Epworth Sleepiness Scale (ESS) score from 6.0 to 4.0, p = 0.015); a significant improvement in subjective sleep quality (median Pittsburgh Sleep Quality Index (PSQI) total score from 7 to 5; p = 0.001) was also observed. Home-PSG showed a significant increase in objective sleep efficiency (SE), both after 3 (from 88.1 to 91.0, p = 0.006) and 12 months (from 87.1 to 91.0, p = 0.006) of treatment. In addition, our data confirmed erenumab effectiveness and safety in migraine prevention.ConclusionOur study demonstrated an improvement in both subjective and objective sleep quality in patients treated with a migraine-preventive therapy. Erenumab, in particular, does not cross the blood-brain barrier (BBB), thus a direct effect on sleep is unlikely. Future studies are needed to better understand the mutual influence between migraine and sleep disorders.

Comparison of the effects of duloxetine and pregabalin on pain and associated factors in patients with knee osteoarthritis.

This study aimed to investigate the effects of duloxetine and pregabalin primarily on pain and functional status in patients with knee osteoarthritis and secondarily on quality of life, depression, anxiety, and sleep disturbance. A total of 66 patients with knee osteoarthritis were randomized to use duloxetine or pregabalin. Patients were evaluated by Visual Analog Scale, Neuropathic Pain Diagnostic Questionnaire, Western Ontario and McMaster University Osteoarthritis Index, Short Form-36, Beck Depression Inventory, Beck Anxiety Inventory, and Pittsburg Sleep Quality Index before the treatment and after 4 and 12 weeks of treatment. Improvements occurred in Visual Analog Scale, Neuropathic Pain Diagnostic Questionnaire, Western Ontario and McMaster University Osteoarthritis Index, Short Form-36 (with an exception of the mental health subgroup scores in duloxetine-treated group), Beck Depression Inventory, and Beck Anxiety Inventory scores in both groups from 4 weeks after baseline. Pittsburg Sleep Quality Index total scores and SF-36 mental health subgroup scores started to improve on the 4th and 12th weeks in pregabalin- and duloxetine-treated groups, respectively. Osteoarthritis pain, a complex outcome with nociceptive and neuropathic components, leads to central sensitization in a chronic phase. Using centrally acting drugs in the control of pain and associated symptoms would increase the probability of treatment success.

APOE ε4 predicts amyloid PET positive in amnesic subjective cognitive decline

AbstractBackgroundSubjective cognitive decline (SCD) has been considered as at risk state to progress to mild cognitive impairment(MCI) or Alzheimer's disease(AD). Apolipoprotein E e4 allele is a well‐known genetic risk for rapid deterioration of cognitive and dementia development. We investigated the effect of APOE ε4 on the brain amyloid pathology and other clinical features in the elderly with SCD.MethodOne hundred and nineteen elderly subjects, 60 or older, complaining of persistent cognitive decline, with 7% to 50% of the memory test score and over 7% of the other tests score were included through neuropsychological tests(Seoul neuropsychological battery, SNSB). Brain magnetic resonance imaging (MRI) volumetry, visual and standardized uptake value ratio (SUVR) analysis of 18F‐Florbetaben brain amyloid‐beta Positron Emission Tomography (PET) were performed. Demographics, physical data, social and physiological functions were also obtained.ResultOf the 119 SCD subjects, 26 (21.8%) had APOE ε4 and 26 (21.8%) had amyloid PET positive. Age was not different between two groups (70.9 V.S. 70.9, p=0.880). Test Z‐score was only marginally lower in Digit span test‐forward (p=0.053) in SCD with APOE ε4. Amyloid PET SUVR value was higher in SCD with APOE ε4 (1.2±0.2 V.S. 1.5±0.3, p=0.001). Regional brain volume including hippocampus and entorhinal cortex were not different in SPM based volumetric ananlysis. Korean_Everyday Cognition subscores, depression scores measured with Patient Health Questionnaire 9, sleep quality measured with Pittsburgh Sleep Quality Index total score, Body Mass Index, and gait speed were not different between two groups.ConclusionWith the baseline data, APOE ε4 was associated with decreased attention and higher brain amyloid accumulation in amnestic SCD. Longitudinal data will be needed to clarify whether APOE ε4 is associated with progression of cognitive dysfunction in SCD. This study was supported by a grant from the Ministry of Health and Welfare, HI18C0530.

Sleep Characteristics and Cognitive Function in Older Adults Without Dementia: The CABLE Study.

The associations between sleep characteristics and cognition are complicated. Alzheimer's disease (AD) pathologies have been proven to be associated with sleep characteristics. We aimed to investigate the associations between sleep characteristics and cognitive function and examine the roles of AD pathologies in modulating the association of sleep duration with cognition. A total of 974 participants who had measurements of cerebrospinal fluid (CSF) amyloid-β (Aβ), phosphorylated tau (P-tau), total tau proteins (T-tau), cognitive function, and sleep characteristics were included from the Chinese Alzheimer's Biomarker and Lifestyle (CABLE) study. Linear regression analyses were utilized to explore the associations of sleep characteristics with cognition. Non-linear regression analyses were utilized to explore the associations of sleep habits with cognition. Causal mediation analyses were conducted to explore the mediation effects of AD pathologies on cognition. The Pittsburgh Sleep Quality Index (PSQI) total score was significantly negatively correlated with Montreal Cognitive Assessment (MoCA) score (p = 0.0176). Long latency (p = 0.0054) and low efficiency (p = 0.0273) were associated with cognitive impairment. Habitual nap behavior was associated with lower MoCA scores (p = 0.0045). U-shaped associations were observed between sleep habits (bedtime and nocturnal sleep duration) and cognition. A causal mediation analysis indicated that P-tau/Aβ42 mediated the association of sleep duration with cognition. These findings showed sleep characteristics were associated with cognitive functions. Sleep habits (duration, bedtime) had U-shaped associations with cognition. AD core pathologies might partially mediate the influence of sleep duration on cognitive impairments.

Associations of Sleep Quality, Anxiety, and Depression with Cognitive and Executive Functions among Community-Dwelling Women Aged ≥ 65 Years: A Cross-Sectional Study.

(1) Background: The objective of this study was to evaluate the associations of sleep quality, anxiety, and depression with cognitive performance, executive functions, and verbal fluency among women aged ≥ 65 years; (2) Methods: A cross-sectional study was conducted on 241 women (72.52 ± 3.93 years). Cognitive performance (Mini-Mental State Examination) and impairment (Montreal Cognitive Assessment), verbal fluency (Isaacs test) and executive function (Trail Making Test), Sleep quality (Pittsburgh Sleep quality Index) and anxiety and depression (Hospital Anxiety and Depression Scale) were determined; (3) Results: The linear regression analysis indicated that anxiety, depression and age, were related to lower Mini-Mental State Examination score (adjusted R2 = 0.306), and age, anxiety and daytime dysfunction were linked to reduced Montreal Cognitive Assessment score (adjusted R2 = 0.248). Age and daytime dysfunction were associated with worse verbal fluency (adjusted R2 = 0.094). Finally, sleep latency, sleep disturbances, the Pittsburgh Sleep quality Index total score were associated with longer times in TMT-A (adjusted R2 = 0.758) and TMT-B (adjusted R2 = 0.508); (4) Conclusions: Sleep quality was associated with cognitive performance, verbal fluency and executive functions. Besides, both anxiety and depression were related with cognitive performance, while only anxiety was linked to executive functions. As for confounders, age was associated with cognitive performance and verbal fluency.

Factors Associated With Perceived Stress Among Dementia Caregivers With Poor Sleep

Poor sleep among family caregivers of individuals with dementia is associated with higher levels of caregiver stress. Modifiable factors that increase risk of stress among caregivers with poor sleep are targets for intervention. This analysis aimed to identify factors associated with greater caregiver stress among caregivers with poor sleep. Baseline data from an ongoing trial of a dyadic sleep intervention program for individuals with dementia and their caregivers with poor sleep quality (defined by Pittsburgh Sleep Quality Index total score > 5; N=21 dyads; mean age 70.8± 11.1 for caregivers, 80.5± 8.3 for care-recipients) were analyzed. Caregiving factors included Zarit Burden Index (ZBI) and SF-12 Short Form Health Survey (SF-12v2). Care-recipient factors included Mini-Mental State Examination (MMSE) and Revised Memory and Behavior Problems Checklist (RMBPC). Stress was measured with the Perceived Stress Scale (PSS). Analyses included Pearson correlations and t-tests. Caring for multiple care-recipients (n=5: 24.8±2.7) was associated with higher (worse) PSS scores than caring for one care-recipient only (n=16: 19.6±3.7, p=0.011). Caregivers with higher PSS also had a significantly higher ZBI score (r=0.53, p=0.015), higher distress related to care-recipient behaviors on the RMBPC (r=0.57, p=0.009) and worse mental health on the SF-12v2 (r= -0.47, p=0.037). PSS was not associated with care-recipient MMSE. These findings suggest that caregivers with poor sleep who care for multiple care-recipients may be at higher risk of stress. This work also identified potential targets (e.g., caregiver burden, mental health, distress related to care-recipient behavior) for reducing stress in this population.

Sleep and diabetes-specific psycho-behavioral outcomes of a new automated insulin delivery system in young children with type 1 diabetes and their parents.

Data on the use of Control-IQ, the latest FDA-approved automated insulin delivery (AID) system for people with T1D 6 years of age or older is still scarce, particularly regarding nonglycemic outcomes. Children with T1D and their parents are at higher risk for sleep disturbances. This study assesses sleep, psycho-behavioral and glycemic outcomes of AID compared to sensor-augmented pump therapy (SAP) therapy in young children with T1D and their parents. Thirteen parents and their young children (ages 7-10) on insulin pump therapy were enrolled. Children completed an initial 4-week study with SAP using their own pump and a study CGM followed by a 4-week phase of AID. Sleep outcomes for parents and children were evaluated through actigraphy watches. Several questionnaires were administered at baseline and at the end of each study phase. CGM data were used to assess glycemic outcomes. Actigraphy data did not show any significant change from SAP to AID, except a reduction of number of parental awakenings during the night (p = 0.036). Parents reported statistically significant improvements in Pittsburgh Sleep Quality Index total score (p = 0.009), Hypoglycemia Fear Survey total score (p = 0.011), diabetes-related distress (p = 0.032), and depression (p = 0.023). While on AID, time in range (70-180 mg/dL) significantly increased compared to SAP (p < 0.001), accompanied by a reduction in hyperglycemia (p = 0.001). These results suggest that use of AID has a positive impact on glycemic outcomes in young children as well as sleep and diabetes-specific quality of life outcomes in their parents.

Cognitive Behavioural Therapy for Insomnia Monotherapy in Patients with Medical or Psychiatric Comorbidities: a Meta-Analysis of Randomized Controlled Trials.

This is a meta-analysis of randomized controlled trials (RCTs) comparing cognitive behaviour therapy for insomnia (CBT-I) monotherapy with active control treatment for insomnia in patients with medical or psychiatric comorbidities. Both international (PubMed, EMBASE, PsycINFO, Cochrane Library) and Chinese (WanFang, and CNKI) databases were systematically searched. The random effects model was used. Thirteen RCTs comparing CBT-I (n = 441) and active controls (n = 412) groups were included. CBT-I group showed significant advantage over active controls at post-treatment assessment in terms of Insomnia Severity Index (ISI; SMD = -0.74), sleep onset latency (SMD = -0.36), wake after sleep onset (SMD = -0.21), sleep quality (SMD = 0.56), Pittsburgh sleep quality index total scores (PSQI; SMD = -0.76) and the total score of dysfunctional beliefs and attitudes about sleep scale (DBAS; SMD = -1.09). Subgroup analyses revealed significant improvement in sleep onset latency in patients with psychiatric disorders (SMD = -0.45), while significant reduction of number of wakeup after sleep onset was found in patients with medical conditions (SMD = -0.31). This meta-analysis found that CBT-I monotherapy had greater efficacy than other active control treatment for insomnia in patients with medical or psychiatric comorbidities.

The effect of Internet addiction on sleep quality in adolescents.

This cross-sectional type study was conducted to investigate the effect of Internet addiction on sleep quality in adolescents. The study was conducted between September and December 2017 in three high schools located in the city center of Erzincan determined according to three socioeconomic levels. The population of the study was composed of 9th, 10th, 11th, and 12th grade students in the high schools determined. In the study, sample group selection was not made and all students, for whom parental permission and student permissions were obtained, were included in the study. A total of 1487 students were included in the study. The average age of adolescents who participated in the study was 16.16 ± 1.19, 60.6% were male, and 27.6% were 9th grader. Adolescents' Young Internet Addiction Test-Short Form (YIAT-SF) total score average was 25.12 ± 9.14 and Pittsburgh Sleep Quality Index (PSQI) total score average was 5.11 ± 3.02. Poor sleep quality was found in 61.6% of adolescents. A positive and statistically significant relationship was found between the YIAT total score and the PSQI total score of adolescents (p < .01). It was determined that adolescents have a moderate Internet addiction, poor sleep quality, and Internet addiction negatively affects sleep quality.

Poor sleep quality among newly diagnosed head and neck cancer patients: prevalence and associated factors

BackgroundHead and neck cancer (HNC) patients often suffer from distress attributed to their cancer diagnosis which may disturb their sleep. However, there is lack of research about poor sleep quality among newly diagnosed HNC patients. Therefore, our aim was to investigate the prevalence and the associated factors of poor sleep quality among HNC patients before starting treatment.Materials and methodsA cross-sectional study was conducted using the baseline data from NET-QUBIC study, an ongoing multi-center cohort of HNC patients in the Netherlands. Poor sleep quality was defined as a Pittsburgh Sleep Quality Index (PSQI) total score of > 5. Risk factors examined were sociodemographic factors (age, sex, education level, living situation), clinical characteristics (HNC subsite, tumor stage, comorbidity, performance status), lifestyle factors, coping styles, and HNC symptoms.ResultsAmong 560 HNC patients, 246 (44%) had poor sleep quality before start of treatment. Several factors were found to be significantly associated with poor sleep: younger age (odds ratio [OR] for each additional year 0.98, 95% CI 0.96–1.00), being female (OR 2.6, 95% CI 1.7–4.1), higher passive coping style (OR 1.18, 95% CI 1.09–1.28), more oral pain (OR 1.10, 95% CI 1.01–1.19), and less sexual interest and enjoyment (OR 1.13, 95% CI 1.06–1.20).ConclusionPoor sleep quality is highly prevalent among HNC patients before start of treatment. Early evaluation and tailored intervention to improve sleep quality are necessary to prepare these patients for HNC treatment and its consequences.

Subgrouping Poor Sleep Quality in Community-Dwelling Older Adults with Latent Class Analysis - The Yilan Study, Taiwan

The manifestation of older adults with poor sleep quality is heterogeneous. Using data-driven classifying methods, the study aims to subgroup community-dwelling older adults with poor sleep quality. Adults aged 65 and older participated in the Yilan study. Poor sleep quality was defined using the Pittsburgh Sleep Quality Index. Latent class analysis with the 7 subscores of the Pittsburgh Sleep Quality Index as the indicators was used to generate empirical subgroups. Differences in comorbidity patterns between subgroups were compared. A total of 2622 individuals, of which 1011 (38.6%) had Pittsburgh Sleep Quality Index -defined poor sleep quality, participated. Three groups for poor sleep quality were specified in the latent class analysis: High Insomnia (n = 191, 7.3%), Mild Insomnia (n = 574, 21.9%), and High Hypnotics (n = 246, 9.4%). The High Insomnia and Mild Insomnia groups shared similar profiles but different severities in the 7 domains of the Pittsburgh Sleep Quality Index. In contrast, the High Hypnotics group had the lowest Pittsburgh Sleep Quality Index total scores and insomnia severity but had similar mental and physical comorbid patterns as the High Insomnia group. This finding suggests that poor sleep quality in community-dwelling older adults had various feature-based subgroups. It also implicates the development of group-centered interventions.